Journal of Neurogastroenterology and Motility 2017; 23(1): 144-144
Enhancing Perception of Chronic Constipation—Time for Educational Input
Neel Sharma
1National University Hospital Singapore, Singapore, 2Harvard Macy Institute, Boston, MA, USA
Published online: January 1, 2017.
© The Korean Society of Neurogastroenterology and Motility. All rights reserved.

cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

TO THE EDITOR: Tamura et al1 have gracefully emphasised the issues with regards to the lack of self-recognition of chronic constipation in an Asian setting. As a medical educationalist and gastroenterologist I wanted to impart discussion as to how we can potentially move this forward. A lack of self-recognition suggests simply one thing; a lack of understanding. Understanding is ultimately based on knowledge and experience. If we as doctors are tasked with educating our patients we can always aim to better enhance their appreciation of disease based pathology. For one thing it is well recognised that there is often a mismatch between how clinicians may or may not adequately explain disease occurrence. Furthermore, our educational practices may be overtly concrete as opposed to ensuring adaptation to the individual in question. In order to enhance patient understanding in this domain the well-recognised domain of threshold concepts comes to mind.2 In brief, a threshold concept enables a more accessible way of understanding which comprises of transformation and integration. Therefore, in determining how best to enhance the educational appreciation of constipation, we should aim to utilize the various theoretical educational elements on offer.

  1. Tamura, A, Tomita, T, and Oshima, T (2016). Prevalence and self-recognition of chronic constipation: results of an internet survey. J Neurogastroenterol Motil. 22, 677-685.
    Pubmed KoreaMed CrossRef
  2. Meyer, JHF, and Land, R (2003). Threshold concepts and troublesome knowledge: linkages to ways of thinking and practising within the disciplines. Improving student learning - theory and practice ten years on, Rust, C, ed. Oxford: Oxford Centre for Staff and Learning Development, pp. 412-424

This Article



Aims and Scope